The chances are, if you are reading this, you have been to your GP, had a blood test and been told to reduce your cholesterol. If that's not you, it might be someone you know - as about 60 per cent of the British population have blood cholesterol levels that increase the risk of heart disease.

The reason you've been told to get your levels down is to reduce that risk. So what now?

Last week in You magazine, we revealed how certain foods can lower cholesterol, with exclusive extracts from the first recipe book to combine them into a diet which could transform your health.

Dr Laura Carr and Ian Marber have written a book, Eat Your Way To Lower Cholesterol, published by Orion

This week, we explain exactly how much of each ingredient you need to eat, alongside more delicious meals for the whole family.

It is important to realise that although you need to know what your cholesterol level is, numbers are not everything. The risk of heart disease depends on a number of factors that also include genetic predisposition, smoking cigarettes, diabetes, high blood pressure, lack of exercise and obesity.

In fact, the majority of those who suffer a heart attack have cholesterol levels that are considered 'normal'. Even so, cholesterol is a fundamental part of the problem.

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If your doctor has recommended medication in the form of statins, you should follow that advice. But whether or not drug treatment is needed, lifestyle is fundamentally important.

A central part of lowering risk is diet - but it's not all about cutting out foods.

Building certain ingredients into your diet can actually lower cholesterol and reduce the risk of heart disease and strokes.

We have looked at the most up-to-date international research and identified six foods for which there is the best evidence for this.

There are some foods, including nuts, olive and rapeseed oils, that may stop LDL from causing damage

Studies have shown a reduction in LDL cholesterol (the bad type, see below) by as much as 20 per cent in three months when a combination of these foods was taken with a healthy diet. And the more often the foods were eaten, the greater the benefit.

With the help of dietician Dr Sarah Schenker, we have included these foods in healthy, easy-to-prepare, delicious recipes - featured in the new book Eat Your Way To Lower Cholesterol. Our hope is that everyone will enjoy them - whether or not they need help with their heart.

What is cholesterol anyway?

People think of cholesterol simply as a bad thing, but it's not. In fact, this fatty, waxy substance is essential for building cells and is also needed to make sex and stress hormones.

Most cholesterol in the blood is produced by the liver, which manufactures it from almost any food you eat. The liver adjusts the amount it makes in response to the amount of cholesterol circulating in the blood.

This is why, when cholesterol-containing foods like eggs or shellfish are eaten, in most people the blood cholesterol doesn't change - as the liver simply makes less.

As well as releasing cholesterol directly into the blood, the liver uses some cholesterol to make bile, a digestive fluid secreted into the gut that helps us absorb fat from the food we eat.

Bile cholesterol is either re-absorbed and recycled by the liver, or is passed out as waste.

We all know that oil and water don't mix, and because cholesterol is a type of fat, and blood is mostly water, they wouldn't get along without an important addition. In order for the cholesterol to be transported easily in the bloodstream, the liver coats it in proteins.

The resulting tiny balls of fat are known as lipoproteins, and it is these we are usually referring to when we talk about cholesterol.

Eat Your Way To Lower Cholesterol, by Ian Marber and Dr Laura Corr, is published by Orion at £16.99

The good... and the bad!

Two types of lipoprotein are low-density lipoprotein (LDL) and high-density lipoprotein (HDL). This is why, when you have a blood test to check your cholesterol levels, your GP may give you more than one number.

The main function of LDL is to carry cholesterol to the cells of the body where it is needed. If there is more than is needed, LDL can build up in spots in the artery walls - a process called atherosclerosis.

Once this starts, the LDL can undergo a chemical change called oxidation - a process akin to butter going rancid - causing further damage to the artery walls and raising the risk of heart disease.

The main function of HDL is to mop up the excess LDL cholesterol and take it away from the cells and artery walls to the liver, where it is either broken down or excreted. The more HDL we have, the better.

So, a person can have high overall cholesterol levels but if much of it is HDL, then they probably won't be told to get their levels down.

How food has an effect

We all know a bit about food and health, whether from old wives' tales, messages from our school days or things we've seen in television adverts.

But many bits of information that we think of as fact have been disproven over the years.

And there is now strong evidence that protection from heart disease and strokes comes just as much from foods we should be including in our diets, as those we should be avoiding.

The latest research shows that eating specific foods can not only lower cholesterol levels but also have wider-ranging benefits for heart health:

Certain foods, such as fibre-rich beans and pulses or oats, stop cholesterol from being absorbed into the blood circulation.

There is also evidence that certain types of fibre actually reduce the amount of cholesterol manufactured by the liver.

In addition, there are some foods, including nuts, olive and rapeseed oils, that may stop LDL from causing damage.

These three key aspects are represented in the six foods outlined on these pages.

DAY 1

It worked for me... My GP is amazed! By Angela Epstein

Angela Epstein

When my GP told me my cholesterol was high - 6.2 when it should have been no more than 5.0 - I was shocked.

As a size ten with a love of swimming, a dislike of dairy and anything creamy and no heart disease in the family, I'd assumed I'd be fine.

Would I have to give up chocolate or my weekly takeaway of fish and chips? Not so, as I discovered on the Eat Your Way To LowerCholesterol plan. I just needed to start eating certain other foods each day.

Now a handful of almonds has become a satisfying treat, while tossing some walnuts into a salad can also give a wholecholesterol-lowering daily dose.

I've never been a huge fan of beans, but swapping potato for butter bean mash is so clever.

I substitute meat for soya mince in a chilli, and oatcakes or wholemeal pitta dipped in olive oil are now a favourite on-the-go snack.

I'll admit I was sceptical, but then the results came through. My overall level had dropped by almost ten per cent, to 5.7 but more importantly, my 'bad' LDL had dropped 30 per cent from 3.9 to 2.7, and my 'good' HDL had risen from 2.1 to 2.7. I'm seriously chuffed... and so is my GP!

Health comment By Dr Laura Corr, consultant cardiologist

Angela has had a great result - but some people may need more than a change of diet to help them lower cholesterol. Diabetes andthyroid problems, as well as alcohol, obesity and some medicines, can raise levels.

And in the UK, about one person in 500 has an inherited condition called familial hypercholesterolaemia, caused by a faulty gene,which causes very high cholesterol levels - but only 15 per cent of people with it are aware of it. It is important to find out if you could have it.

Do recheck your LDL and HDL levels with your GP after 12 weeks on the diet.

Know your level, eat well and get regular checks - By Laura Corr

By Laura Corr. If you want to know something not covered, email us at health@mailonsunday.co.uk

Cholesterol
is a complex subject and a rapidly evolving area of medical science.
Here, our expert tackles some frequently asked questions - but if you
want to know something not covered, email us at
health@mailonsunday.co.uk.

How is cholesterol measured?

It can
only be done via a blood test. In the UK and Europe, cholesterol is
measured in millimoles per litre of blood (mmol/l). Most people simply
know a number, which is fine and easy to remember.

What is considered high?

The
Department of Health recognises a total cholesterol level of more than
5.0 or an LDL cholesterol level more than 3.0 as high. The LDL level is
calculated from the total and the HDL levels using a mathematical
formula, so it is actually the ratio between total and HDL cholesterol
that matters most. If you are at risk of heart disease due to other
factors such as a family history, if you are overweight, a smoker, or
inactive, or you already have heart problems, recommended levels are a
total of less than 4.0 and an LDL of less than 2.0. Your HDL should be
as high as possible.

Why is my cholesterol high?

A common cause
is eating the wrong foods and lack of exercise. However, there is strong
scientific evidence that genes play a role in the natural variation of
cholesterol levels as well as how we respond to cholesterol in the diet.
High cholesterol can also run in the family due to a problem called
familial hypercholesterolaemia. Other causes include an underactive
thyroid gland, obesity, drinking a lot of alcohol and some rare kidney
and liver disorders.

Does a high reading mean I'm going to have a heart attack?

No,
it is just one of a number of risk factors. However, there is a strong
link between high cholesterol levels and the risk of heart disease. But
levels vary and, in fact, most people who have heart attacks will be
within the top of the 'normal' range. How long before you know how well the diet works?Studies
vary in length from one to three months or more, but if you adopt all
our healthy eating recommendations, you should see benefits within three
months.

How high does your cholesterol level need to be before you have to go on cholesterol-lowering statins?

It
doesn't have to be very high. It depends more on your risk of
cardiovascular disease than on your cholesterol blood tests - doctors
will recommend statins to patients who have low levels of cholesterol,
while people with higher levels may not be at sufficiently high risk to
benefit.

If I am already on statins, why do I need to watch what I eat?

Statins
are highly effective but may not be enough to get your levels right
down. Also, they are not very good at raising your HDL cholesterol. Most
people tolerate statins without any problems but higher doses do
increase the risk, so a diet to improve cholesterol will help.

If I reduce my cholesterol, does it mean I won't have a heart attack?

There
is no guarantee. However, it will tilt the odds in your favour.
Reducing cholesterol may not be enough if you continue to smoke, as this
is one of the most significant risk factors in heart disease.

How often should I have a cholesterol test?

If
you have a family history of high cholesterol, strokes or heart
attacks, test at the age of 20 - or younger if your doctor is worried.
If not, test at 40 and then at least every five years after that.